Nutritional assessment of failure to thrive

ABSTRACT

Failure to thrive is a common problem that is met by pediatricians all over the world. 40 cases of children with FTT aged 1-5 years and 10 normal children of the same age as a conttrol group were studied. All were subjected to comperhensive history taking, through physical examination including anthroprometric assessment [weight, height, head and mid-arm circumferences] and laboratory investigations with particular to estimation of nutritional markers [plasma prealbumin, fibronectin and retinal binding protein]. Our results showed a statistically, significant difference with [P<0.001] in the weight and mid-arm circumference between cases of FTT and control group.Statistical non significan't difference between control group and cases in respect to supine length or height and head circumference [All parameters as a percentage of 50[th] percentile of normal Egyptian growth curves] there was statistical difference in the control levels and our cases of FTT in all nutritional markers. The mean prealbumin level in the control group was 25.4 +/- 9.2 mg/dL compared to the organic group 9.57 mg/dL with P value <0.0001 and in non-organic cases was 12.1 mg/dL with P -value [< 0.005] which is highly significant. The mean plasma fibronectin level in the control group was 21.5 +/- 6.8 mg/dL compared to the mean level in FTT cases 11.7 +/- 4.18 mg/dL with P-value [<0.05]. In the organic group mean level was 10. 15 +/- 3.2 mg/dL with P value [< 0.0005] and in non-organic group the mean fibronectin level was 12.68 +/- 2.3 mg/dL with P-value [< 0.05] compared to control group. Retinol binding protein mean level in control group was 3.82 +/- 1.1 mg/dL while in FTT cases was 1.81 +/- 0.69 mg/dL with statstically non-stignificant difference P-value [< 0.25]. We concluded that the incidence of non-organic failure to thrive cases was higher than the organic causes, most likely in children < 5 years. Ignorance, poverty, frequent infections, cultural customs or unstable families are the main causes in our developing countries